Barbui T, Cortelazzo S, Rossi A, Viero P, Bellavita P, Buelli M, Fracassetti D, Bassan R, Comotti B, Marchioli R, Marfisi R M, Rambaldi A
Division of Hematology, Ospedali Riuniti di Bergamo, Italy.
Cancer Chemother Pharmacol. 1996;38 Suppl:S110-4. doi: 10.1007/pl00006735.
Circulating progenitor cells (CPCs) mobilized from bone marrow will replace the use of bone marrow transplantation because hematopoietic reconstitution is more rapid using the former technique. We report on early and late recovery of hematopoiesis after CPC transplantation in patients with non-Hodgkin's lymphoma (NHL) and analyze the role of variables possibly influencing engraftment. From December 1992 through September 1995, 57 consecutive NHL patients were enrolled in this study. Patients could be divided into 2 groups: the first comprised 32 patients with untreated diffuse large-cell lymphoma and unfavorable prognostic factors; the second comprised 25 patients with resistant or relapsing NHL of low-and high-grade histology. All patients received high-dose chemotherapy (carmustine, cytarabine, etoposide, and melphalan; BEAM) followed by CPC transplantation. In all, 25 patients were treated with granulocyte colony-stimulating factor (G-CSF) after CPC administration. The time to short-and long-term hematologic engraftment and variables correlating with multilineage long-term reconstitution were examined. The time to bilineage (neutrophils and platelets) hematopoietic reconstitution did not differ in G-CSF-treated and-untreated patients. In contrast, the time taken to reach a neutrophil count of 0.5 x 10(9)/1 and a WBC of 1 x 10(9)/1 was significantly shorter in G-CSF-treated patients. Overall, 33 patients achieved long-term, complete trilineage engraftment after a median of 117 days from CPC transplantation. The leukocyte count was the first parameter to reach full engraftment and hemoglobin was the last. According to Kaplan-Meier analysis, 80% of the patients are projected to reconstitute fully at 12 months after transplantation. Univariate and multivariate analyses showed that sustained, long-term hematopoiesis was significantly related to a younger age, an early bilineage reconstitution, and the quantity of CD34+ cells infused.
从骨髓动员的循环祖细胞（CPCs）将取代骨髓移植的应用，因为采用前一种技术造血重建更快。我们报告非霍奇金淋巴瘤（NHL）患者接受CPC移植后造血功能的早期和晚期恢复情况，并分析可能影响植入的变量的作用。从1992年12月至1995年9月，57例连续的NHL患者被纳入本研究。患者可分为两组：第一组包括32例未经治疗的弥漫性大细胞淋巴瘤且预后不良的患者；第二组包括25例低级别和高级别组织学类型的耐药或复发NHL患者。所有患者均接受大剂量化疗（卡莫司汀、阿糖胞苷、依托泊苷和美法仑；BEAM方案），随后进行CPC移植。总共25例患者在给予CPC后接受了粒细胞集落刺激因子（G-CSF）治疗。研究了短期和长期血液学植入的时间以及与多系长期重建相关的变量。G-CSF治疗组和未治疗组达到双系（中性粒细胞和血小板）造血重建的时间没有差异。相比之下，G-CSF治疗的患者达到中性粒细胞计数0.5×10⁹/L和白细胞计数1×10⁹/L所需的时间明显更短。总体而言，33例患者在接受CPC移植后中位数117天实现了长期、完全的三系植入。白细胞计数是第一个达到完全植入的参数，血红蛋白是最后一个。根据Kaplan-Meier分析，预计80%的患者在移植后12个月可完全重建。单因素和多因素分析表明，持续的长期造血与较年轻的年龄、早期双系重建以及输入的CD34⁺细胞数量显著相关。
